3 Receiving Of A Radioactive Package 1. Date and time 2. What is the content of the package? 3. Does the content match invoice? (circle one) Yes or No 4. Inspect the package on arrive. a. Is there damage? (circle one) Yes or No b. If yes, describe the damage. Was the RSO contacted? c. What is the package s label (circle one) White I, Yellow II, Yellow III) d. surface = mr/hr e. 1 meter = mr/hr 5. Complete 100 cm 2 wipe test of the package a. Results in cpm = b. What is the well counter efficiency? c. Results in dpm = 6. Monitor the empty package to assure that there is no radioactive contamination Removable contamination should not exceed uci or 2200 dpm/cm 2

8 Geometry Variation Dose Calibrator Date Time the procedure was Started Ended Volume in ml Measured Activity Expected Activity Percent Error Draw up between 1 10 mci of 99m Tc into a three ml syringe and expand to 0.5 ml. Measure and record each reading as quickly as possible. Background should not be an issue since that was measured with the morning QC. DC automatically subtracts it to give you net activity. Continue to expand you activity by 0.5mL intervals, measure it to the point where 3.0 ml is recorded. Activity levels should vary less than 10%. Greater amounts require a the determination of the correction factor. Determine the difference between the measured and expected levels of activity for each volume and chart your answer above. Calculate % Error(s) for each Questions 1. Is the variation acceptable? 2. If no, then what is/are the correction factors and where should it be applied?

10 Kit Compounding and QC One Strips Show your calculations Name of the Clinical Affiliate Name of the pharmaceutical Amount of 99m Tc added to the kit mci. Solution is ml. Amount of saline used to expand the kit ml. Kit concentration is mci/ml? How did you make the kit (ingredients, mixing, heating, sonic bath, incubation time?) What color is the compounded solution? Actual measured amount of activity placed into the vial? mci What is the patient s prescribed dose? mci? How many ml are needed from the vial? ml What was the dose measured in the dose calibrator? mci? (Calculate data below) Using One TLC Strip Write in the values and calculate the percentage.

11 Kit Compounding and QC Two Strips Show your calculations Name of the Clinical Affiliate Name of the pharmaceutical Amount of 99m Tc added to the kit mci. Solution is ml. Amount of saline used to expand the kit ml. Kit concentration is mci/ml? How did you make the kit (ingredients, mixing, heating, sonic bath, incubation time?) What color is the compounded solution? Actual measured amount of activity placed into the vial? mci What is the patient s prescribed dose? mci? How many ml are needed from the vial? ml What was the dose measured in the dose calibrator? mci? (Calculate data below) Using Two TLC Write in the values and calculate the percentages.

12 Kit Compounding and QC of Labeled RBCs Show your calculations Name of the Clinical Affiliate Labeling Process 1. Take a 5 ml syringe and wet it with heparin. Then remove 3 ml of patient s whole blood and place this into a reaction vial. 2. Mix gently the contents within the reaction vial and the whole blood and let stand for 5 minutes. 3. To the reaction vial add syringe 1 (sodium hypochlorite), invert 4-5 times, then add contents from syringe 2 (citric acid, sodium citrate, and dextrose) and invert vial another 4-5 times. 4. Add mci of 99m TcO 4 - in no greater than a 3 ml solution into the reaction vial and invert 4-5 times. Now let the reaction vial stand for 20 minutes before injecting the dose into the patient. How much activity did you add to the reaction vial in how many ml? mci and ml 5. What was the measured dose to the patient? mci QC the Bound RBCs 1. Remove 0.2 ml of RBC from reaction vial and place into test tube. 2. Add 2.0 ml of saline and gently mix the solutions before centrifuging for 5 minutes. Make use the centrifuge is balanced with an equal amount of liquid at the opposite end. In practice, usually a second tubes of RBCs are used, in case someone messes up the pipetting of plasma. 3. Remove supernatant and place into separate test tube. 4. Measure supernatant (A) in dose calibrator and measure packed cells (B) in the dose calibrator. 5. Calculate the Radiochemical purity of the tagged cells

13 SPILL/CONTAMINATION PROCEDURES FOR LOW AND HIGH DOSE UNSEALED SOURCES MINOR SPILLS OF LIQUIDS AND SOLIDS 1. NOTIFY: Notify persons in the area that a spill has occurred. 2. PREVENT THE SPREAD OF CONTAMINATION: Cover the spill with absorbent paper. 3. ABSORB LIQUID: Wear gloves and protective clothing such as a lab coat and booties, and clean up the spill using absorbent paper. Carefully fold the absorbent paper with the clean side out and place in a bag labeled caution radioactive material for transfer to a radioactive waste container. All contaminated gloves and any other contaminated disposable material should be placed in the bag. 4. SURVEY: With a G.M. survey meter, check for removable contamination to ensure contamination levels are below trigger levels. Check the area around the spill. Also, check hands, clothing, and shoes of self and anyone else who may be potentially contaminated. 5. DECONTAMINATE: Clean the area with a soap solution. Perform a swipe survey to check for removable contamination. Continue decontamination efforts until swipe surveys show less than the trigger level. 6. REPORT: Report the incident to the Radiation Safety Section and Nuclear Medicine Manager. Complete Spill/Contamination Incident Report and deliver to Nuclear Medicine Manager. MAJOR SPILLS OF LIQUIDS AND SOLIDS 1. CLEAR THE AREA: Notify all persons not involved in the spill to vacate the room. 2. PREVENT THE SPREAD OF CONTAMINATION: Cover the spill with absorbent pads labeled caution radioactive material, but do not attempt to clean it up. To prevent the spread of contamination, clearly indicate the boundaries of the spill and limit the movement of all personnel who may be contaminated. 3. SHIELD THE SOURCE: If possible, the spill should be shielded, but only if it can be done without further contamination or significant increase in radiation exposure. 4. CLOSE THE ROOM: Close the room and lock or otherwise secure the area to prevent entry. 5. CALL FOR HELP: Notify the Radiation Safety Section immediately. Notify Nuclear Medicine Manager immediately. Complete Spill/Contamination Incident Report and deliver to Nuclear Medicine Manager (following personnel decontamination procedure). 6. PERSONNEL DECONTAMINATION: Remove contaminated clothing and flush contaminated skin with lukewarm water and then wash with mild soap. If contamination remains, induce perspiration by covering the area with plastic. Then wash the affected area again to remove any contamination that was released by the perspiration. RADIATION SAFETY SECTION: NUCLEAR MEDICINE MANAGER:

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